Power of touch: How specialized massage helps cancer patients

Some types of massage can help break up scar tissue, reduce post-surgery lymphedema, doctors say

Feb. 18, 2014

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By Andy Koopmans and Linda Carroll

Karen James, a Seattle-area licensed massage practitioner, specializes in working with cancer patients.

Robert Hood / Fred Hutch

After multiple surgeries for melanoma, Joanne Farmer’s cancer was vanquished, but she was left chronically stiff and sore. With traditional medicine offering no help, Farmer turned to alternative therapies, including massage.

“I had some reservations about getting massage because of things I’d heard people saying about how you’re not supposed to,” said Farmer, 49. “But I decided to take the risk anyway because I felt my body really needed it.”

Over the years, massage has not only improved Farmer’s spirits, but it’s also eliminated her aches and pains. “I am calmer,” Farmer said. “I can fall asleep more easily. My stiffness and phantom pains are gone. And most amazingly, so is my scar tissue.”

Massage is becoming increasingly popular as an add-on for cancer patients. Turns out, the age old therapy has a broad range of healing effects, from amelioration of adhesions to easing of symptoms like pain and fatigue. And that has led to more acceptance in traditional settings.

Part of the turnaround is due to a better understanding of what the therapy does and does not do.

For years oncologists told their patients to steer clear of massage, fearing that the manipulation of skin and muscle might cause cancer to spread, said Dr. Benjamin O. Anderson, chair of the Breast Health Global Initative in the Public Health Division of Fred Hutchinson Cancer Research Center.

“But that’s been proven not to be true. We also know now that it can help with the scarring process and we actually encourage massage when women start to get adhesions,” said Anderson, who also directs the Breast Health Center at Seattle Cancer Care Alliance (SCCA) and sees patients at the University of Washington.

Adhesions, Anderson explained, can form as the body tries to heal after a surgery.

“When skin touches down to muscle, it can stick like superglue instead of being able to be mobile,” he said. “Massage can break up those adhesions and help maintain, and in some situations, regain, mobility.”

Another cancer massage technique that has become popular is manual lymphatic drainage. Therapists use gentle pressure in rhythmic circular movements to stimulate lymph flow and encourage drainage when there’s been an abnormal buildup of fluids.

A common complication after surgery for breast and ovarian cancer is edema, said Dr. Julie Gralow, a professor of medical oncology at the University of Washington and director of breast medical oncology at SCCA. “Lymphedema is basically the backup of lymph fluid frequently caused by scarring and swelling in the area. Massage helps move the fluid through the whole lymph system.”

This kind of massage requires specialized training, Gralow said.

It’s one of the types of therapy offered by Karen James, a Seattle-area licensed massage practitioner who specializes in working with cancer patients. It was James who helped banish Farmer’s pain.

“Some of the most rewarding experiences I have are when a patient is having complications with physical restrictions from lymphedema,” James said. “I can use the [manual lymphatic drainage] technique to provide relief. The release of fluids can increase mobility and function for patients and make them feel much better.”

Like many alternative therapies, massage hasn’t gotten much attention in the main stream medical literature. But a smattering of small studies suggests that the therapy can help children with pain and anxiety during cancer treatments and adults with fatigue and nausea associated with chemotherapy.

A 2013 study published in Applied Nursing Research compared 20 patients who got back massages during chemotherapy to 20 who did not. The researchers found that massage helped reduce anxiety during and after chemotherapy and also helped with fatigue.

Another study explored the use of massage in 52 Portuguese children who were on a hospital cancer ward. Researchers found that massage could decrease pain intensity allowing children to be more active, according to the report published in 2013 in the Jornal de Pediatria.

While reports like these are suggestive, cancer specialists would prefer to see much larger studies.

Gralow said she’d welcome some hard evidence on the benefits of massage therapy.

Without that evidence doctors have to go on anecdotal reports. “I do think that for a subset of patients massage can help with relaxation and the rejuvenation that comes from it can have a very positive effect,” she said.

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